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Vitamin D endocrine system and COVID-19: treatment with calcifediol

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dc.contributor.author Quesada-Gómez, J.M.
dc.contributor.author López-Miranda, José
dc.contributor.author Entrenas-Castillo, Marta
dc.contributor.author Casado-Díaz, Antonio
dc.contributor.author Nogués Solan, Francesc Xavier
dc.contributor.author Mansur, José Luis
dc.contributor.author Bouillon, Roger
dc.date.accessioned 2022-11-29T07:41:25Z
dc.date.available 2022-11-29T07:41:25Z
dc.date.issued 2022
dc.identifier.citation Quesada-Gomez JM, López-Miranda J, Entrenas-Castillo M, Casado-Díaz A, Nogués Solans X, Mansur JL, et al. Vitamin D endocrine system and COVID-19: treatment with calcifediol. Nutrients. 2022 Jun 29; 14(13): 2716. DOI: 10.3390/nu14132716
dc.identifier.issn 2072-6643
dc.identifier.uri http://hdl.handle.net/10230/55029
dc.description.abstract The COVID-19 pandemic is the greatest challenge facing modern medicine and public health systems. The viral evolution of SARS-CoV-2, with the emergence of new variants with in-creased infectious potential, is a cause for concern. In addition, vaccination coverage remains in-sufficient worldwide. Therefore, there is a need to develop new therapeutic options, and/or to optimize the repositioning of drugs approved for other indications for COVID-19. This may include the use of calcifediol, the prohormone of the vitamin D endocrine system (VDES) as it may have potential useful effects for the treatment of COVID-19. We review the aspects associating COVID-19 with VDES and the potential use of calcifediol in COVID-19. VDES/VDR stimulation may enhance innate antiviral effector mechanisms, facilitating the induction of antimicrobial peptides/autophagy, with a critical modulatory role in the subsequent host reactive hyperinflammatory phase during COVID-19: By decreasing the cytokine/chemokine storm, regulating the renin-angiotensin-bradykinin system (RAAS), modulating neutrophil activity and maintaining the integrity of the pulmonary epithelial barrier, stimulating epithelial repair, and directly and indirectly decreasing the increased coagulability and prothrombotic tendency associated with severe COVID-19 and its complications. Available evidence suggests that VDES/VDR stimulation, while maintaining optimal serum 25OHD status, in patients with SARS-CoV-2 infection may significantly reduce the risk of acute respiratory distress syndrome (ARDS) and severe COVID-19, with possible beneficial effects on the need for mechanical ventilation and/or intensive care unit (ICU) admission, as well as deaths in the course of the disease. The pharmacokinetic and functional characteristics of calcifediol give it superiority in rapidly optimizing 25OHD levels in COVID-19. A pilot study and several observational intervention studies using high doses of calcifediol (0.532 mg on day 1 and 0.266 mg on days 3, 7, 14, 21, and 28) dramatically decreased the need for ICU admission and the mortality rate. We, therefore, propose to use calcifediol at the doses described for the rapid correction of 25OHD deficiency in all patients in the early stages of COVID-19, in association, if necessary, with the new oral antiviral agents.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher MDPI
dc.rights Copyright © 2022 by Quesada-Gomez JM, López-Miranda J, Entrenas-Castillo M, Casado-Díaz A, Nogués Solans X, Mansur JL, et al. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Vitamin D endocrine system and COVID-19: treatment with calcifediol
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.3390/nu14132716
dc.subject.keyword COVID-19
dc.subject.keyword SARS-CoV-2
dc.subject.keyword Calcifediol
dc.subject.keyword Calcitriol
dc.subject.keyword Cholecalciferol
dc.subject.keyword Vitamin D endocrine system
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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